This is an open label, first-in-man clinical trial to assess safety and tolerability of CEB-01 PLGA membrane in patients with recurrent or locally advanced retroperitoneal soft tissue sarcoma after surgery. The trial will be conducted in 3 dose-escalation cohorts (3 patients each, enrolling patients one by one, after 4 weeks of observation and agreement of Scientific Committee and DMC) and in an expansion cohort, using the highest safe and tolerable dose. The study will follow a 3+3 modified design; dose escalation will follow a modified Fibonacci method. CEB-01 carrying a SN-38 dose between 9 and 36 mg will be placed in the surgical bed at the time of tumor resection.
CEB-01 is a poly(lactic-co-glycolic acid) (PLGA) polymeric drug with a delivery system loaded with SN-38, and will be placed in the surgical bed at the time of tumor resection. CEB-01 carrying a SN-38 dose between 9 and 36 mg will be administered. CEB-01 will be placed on all surfaces that were in contact with and/or were infiltrated by the tumor. Confirmatory central reviewing of diagnosis will be performed for all patients, using tumor samples obtained during surgery; additionally, patients will also be included according to local Pathological Anatomy (PA) diagnosis. Patients will be followed-up once every week during the first 8 weeks of the study, and then every 2 weeks up to 12 weeks after implantation of CEB-01. Thereafter, follow-up schedule will be as per normal practice until study completion. Efficacy assessment will be performed by Magnetic Resonance Imaging (MRI) \[Computed tomography (CT) scan and Positron Emission Tomography (PET-CT) are also allowed\] according to RECIST 1.1 criteria. Baseline image determination will be performed at week 12 (±3 days) after surgery; if the image analysis is not conclusive due to wound healing in the tumor bed, it will be repeated on week 16 (±3 days) post-surgery, and every 12 weeks thereafter. A pharmacokinetic assessment of SN-38 will be performed in all patients, and the Cmax, Tmax, half-life, and area under the time-drug concentration curve (AUC) of the drug will be determined. Blood samples will be collected at baseline and at 8 time points after CEB-01 implantation. Assessment of adverse events, safety, and toxicity will be performed according to the Common Terminology Criteria for Adverse Events (CTCAE - version 5.0) at each patient visit from the time of Informed Consent until the end of the study. Quality of Life based on EORTC Quality of Life Questionnaire (QLQ) 30 will be measured prior surgery, at month 1 and month 3.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
21
CEB-01 is a polymeric drug with a delivery system loaded with SN-38, and will be placed in the surgical bed at the time of tumor resection.
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
Hospital Universitario Vall d'Hebron
Barcelona, Spain
Hospital General Universitario Gregorio Marañón
Madrid, Spain
Fundación Jiménez Díaz
Madrid, Spain
Hospital Universitario y Politécnico La Fe
Valencia, Spain
Recommended Doses for Phase II (Maximum tolerated dose)
The number of patients experiencing dose limiting toxicities during the Dose Limiting Toxicities (DLT) observation period of 2 weeks.
Time frame: Through 2 weeks
Frequency of Adverse Events (AEs) (Safety)
Frequency of adverse events reported classified by type and severity.
Time frame: Through study completion, average 2 years
Frequency of Treatment Related Adverse Events (TRAEs) (Toxicity)
Frequency of treatment related adverse events reported classified by type and severity.
Time frame: Through study completion, average 2 years
Time to local relapse (TTLR)
Time from the start of treatment to the date of local relapse according to the RECIST 1.1 criteria, or death due to any cause. Those patients who are alive and have not relapsed at the last follow-up, will be censored at the date of the last follow-up. Relapse definition: For patients in which R0 is obtained by surgery, relapsed should be considered when disease reappears with size \> 1 cm (measurable disease). For patients with R1 or R2, RECIST 1.1 guideline should be used for disease progression definition.
Time frame: Through study completion, average 2 years
Progression Free Survival (PFS)
Time from the start of treatment to the date of the first progression according to the RECIST 1.1 criteria, or death due to any cause. Those patients who are alive and have not progressed at the last follow-up, date of progression will be censored at the date of the last follow-up.
Time frame: Through study completion, average 2 years
Overall Survival (OS)(until 24 months of Follow Up (FU))
Median of overall survival. Time from the start of the trial treatment to the date of exitus for any cause. In those patients who are alive at the last follow-up, OS will be censored by the date of the last follow-up in which the patient was alive.
Time frame: Through study completion, average 2 years
Quality of life: EORTC QLQ 30
Questionnaire developed and validated to assess the quality of life of cancer patients.
Time frame: Prior to surgery, at month 1 and month 3 after surgery
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